REPORT OF A CASEA 67-year-old man from southern Arkansas presented with a 2-year history of slowly progressive asymptomatic annular patches and plaques. He had no systemic symptoms and was otherwise healthy except for chronic obstructive pulmonary disease. He denied any travel out of the country. The findings of a previous biopsy had been reported as consisent with sarcoidosis, and the patient was treated with hydroxychloroquine and prednisone, without benefit.Physical examination revealed multiple large, nonscaly, annular, erythematous plaques with hypopigmented, slightly atrophic centers on the trunk and proximal aspect of the extremities. The plaques varied in size from 3 to 8 cm in diameter (Figure 1 and Figure 2) and exhibited decreased sensation in their centers. The scalp and groin were spared. There was no lymphadenopathy or organomegaly.A biopsy specimen obtained from an erythematous area on the trunk and stained with hematoxylin-eosin is shown in Figure 3 and